A Comparison of the Long-Term Care Systems in Norway and England.

Background: In a context of rapid population ageing, most countries face major challenges to prepare their long-term care systems to meet rising demands. It is vital that research examines how systems can adapt to these demographic changes. International comparisons between long-term care systems can support the identification of shared lessons on the advantages and disadvantages of different systems and associated outcomes. Objective: To analyse and compare the long-term care systems in Norway and in England and identify lessons from this comparison. Method: Using Donabedian's structure-process-outcome framework, this comparative overview analysed the commonalities and differences between the two systems. Data were identified from Government websites, relevant publications, and websites from key national sector organisations from the time period in which the study was conducted (2021-2025). Results: The Norwegian and English systems exhibit more similarities than differences. The most notable differences emerged in the structure component, particularly in terms of funding mechanisms and the degree of care integration. Differences were also evident in the outcome component, where national outcome measures are less systematically embedded in the Norwegian system. In contrast, the process component revealed that both countries have implemented similar initiatives to address shared challenges within their services. Conclusion: We argue that to build a system fit for the future, we need to confront elements currently unaddressed and to understand the interdependence within the triad of care (care recipient-informal carer-workforce), as well as its gendered nature.